How retinoic acid and arsenic transformed acute promyelocytic leukemia therapy. (11th October 2022)

• Record Type: Journal Article
• Authors: Korsos, Victoria; Miller Jr, Wilson H
• Is Part Of: Journal of molecular endocrinology. Volume 69:Number 4(2022)
• Page Start: T69
• Page End: T83
• Publication Date: 2022-10-11
• Subjects: oncology -- retinoic acid -- receptors -- transcription; Molecular endocrinology -- Periodicals; Endocrinology -- Periodicals; 616.407
• DOI: 10.1530/JME-22-0141
• Languages: English
• ISSNs: 0952-5041

Abstract

Abstract : Acute promyelocytic leukemia (APL) is associated with severe coagulopathy leading to rapid morbidity and mortality if left untreated. The definitive diagnosis of APL is made by identifying a balanced reciprocal translocation between chromosomes 15 and 17. This t(15;17) results in a fusion transcript of promyelocytic leukemia ( PML ) and retinoic acid receptor alpha ( RARA ) genes and the expression of a functional PML/RARA protein. Detection of a fused PML/RARA genomic DNA sequence using fluorescence in situ hybridization (FISH) or by detection of the PML/RARA fusion transcript via reverse transcriptase polymerase chain reaction (RT-PCR) has revolutionized the diagnosis and monitoring of APL. Once confirmed, APL is cured in over 90% of cases, making it the most curable subtype of acute leukemia today. Patients with low-risk APL are successfully treated using a chemotherapy-free combination of all-trans retinoic acid and arsenic trioxide (ATO). In this review, we explore the work that has gone into the modern-day diagnosis and highly successful treatment of this once devastating leukemia.